Structures and Function of the Skin

Every question here, with the answer

1. A nurse is preparing to weigh a stable newborn shortly after birth. Which action best supports the newborn’s thermoregulation during weighing?

   1. Place the skin temperature probe over the back or shoulders.
   2. Delay drying the newborn until after the weight is obtained.
   3. Place the newborn near an air vent to prevent overheating.
   4. Use a warm cover on the scale before placing the newborn on it.

   Answer: Use a warm cover on the scale before placing the newborn on it.

   Using a warm cover on the scale reduces heat loss through conduction, which is important because newborns have difficulty regulating temperature. The other options increase heat loss or conflict with the guidance to avoid drafts and avoid placing probes over brown fat areas.

2. A nurse is assessing a patient with dark skin for possible pallor. Which assessment location is most appropriate?

   1. The palms and soles only
   2. Areas with freckles or sun exposure
   3. The gums or palpebral conjunctiva
   4. The abdomen only

   Answer: The gums or palpebral conjunctiva

   The section explains that pallor may not appear the same in darker skin, so the nurse should assess mucous membranes such as the gums or palpebral conjunctiva. The other sites may be part of a general skin assessment but are not identified as the appropriate way to assess pallor in this context.

3. An older adult with diabetic neuropathy is being seen for a sore on the foot and says, “I’m not sure how I got it.” Which teaching points should the nurse include? Select all that apply.

   1. Assume decreased sensation is a normal change that does not require action.
   2. Be aware of surroundings to avoid injury.
   3. Check the feet every day for cuts, scrapes, or bruises.
   4. Avoid checking the feet unless there is pain.
   5. Try to manage blood sugar with diet, exercise, and medications.

   Answer: Be aware of surroundings to avoid injury., Check the feet every day for cuts, scrapes, or bruises., Try to manage blood sugar with diet, exercise, and medications.

   Decreased sensation can make injuries harder to notice, so daily foot checks and environmental awareness are important. The section also links diabetic neuropathy with uncontrolled blood sugar and emphasizes managing blood sugar; waiting for pain or dismissing sensation changes would increase risk of injury.

4. A nurse is preparing to administer a medication that can be absorbed through the skin. Which action best protects the nurse from accidental exposure?

   1. Apply the medication with bare hands and wash afterward.
   2. Wear gloves when handling the medication.
   3. Avoid patient teaching because absorption only occurs locally.
   4. Use extra lotion on the hands before handling it.

   Answer: Wear gloves when handling the medication.

   Because substances on the skin may enter the bloodstream, appropriate handling is needed to prevent accidental absorption. The section specifically gives fentanyl as an example where gloves should be worn; the other options do not adequately prevent exposure or contradict the absorption risk.

5. A nurse is teaching new parents why infant skin requires especially careful handling. Which statements are consistent with the section? Select all that apply.

   1. Infants have a thinner epidermis than adults.
   2. Friction may easily separate the epidermis and dermis, causing blisters or skin breakdown.
   3. Infant skin is more pigmented than adult skin, which protects against sun damage.
   4. Substances absorb more readily through infant skin than adult skin.
   5. Infants have less subcutaneous tissue, so they can lose more heat through the skin’s surface.

   Answer: Infants have a thinner epidermis than adults., Friction may easily separate the epidermis and dermis, causing blisters or skin breakdown., Substances absorb more readily through infant skin than adult skin., Infants have less subcutaneous tissue, so they can lose more heat through the skin’s surface.

   The section describes infant skin as thinner, more absorbent, more prone to layer separation from friction, and associated with greater heat loss because of less subcutaneous tissue. It also states that infant skin is less pigmented regardless of ethnicity, increasing risk for sun damage, so the statement that infant skin is more pigmented is incorrect.

6. During a 6-month well-baby visit, a nurse sees bluish areas on the infant’s back and is concerned about bruising. The caregiver says the areas are “Mongolian spots.” Which information from the caregiver is most consistent with dermal melanocytosis?

   1. The spots appear only on the palms and soles.
   2. The spots first appeared last week, at 6 months of age.
   3. The spots first appeared when the infant was about 2 weeks old.
   4. The infant cries whenever the areas are touched.

   Answer: The spots first appeared when the infant was about 2 weeks old.

   Dermal melanocytosis (formerly called Mongolian spots) consists of pigmented skin lesions that may be present at birth or develop within the first few weeks of life, and they may disappear by childhood. Spots that began at about 2 weeks fit this pattern; new spots at 6 months, tenderness, or other features not described in the section would call for further assessment.